Abstract | OBJECTIVES: Professional judgment is necessary to assess occupational exposure in population-based case-control studies; however, the assessments lack transparency and are time-consuming to perform. To improve transparency and efficiency, we systematically applied decision rules to questionnaire responses to assess diesel exhaust exposure in the population-based case-control New England Bladder Cancer Study. METHODS: 2631 participants reported 14 983 jobs; 2749 jobs were administered questionnaires ('modules') with diesel-relevant questions. We applied decision rules to assign exposure metrics based either on the occupational history ( OH) responses ( OH estimates) or on the module responses (module estimates); we then combined the separate OH and module estimates ( OH/module estimates). Each job was also reviewed individually to assign exposure (one-by-one review estimates). We evaluated the agreement between the OH, OH/module and one-by-one review estimates. RESULTS: The proportion of exposed jobs was 20-25% for all jobs, depending on approach, and 54-60% for jobs with diesel-relevant modules. The OH/module and one-by-one review estimates had moderately high agreement for all jobs (κ(w)=0.68-0.81) and for jobs with diesel-relevant modules (κ(w)=0.62-0.78) for the probability, intensity and frequency metrics. For exposed subjects, the Spearman correlation statistic was 0.72 between the cumulative OH/module and one-by-one review estimates. CONCLUSIONS: The agreement seen here may represent an upper level of agreement because the algorithm and one-by-one review estimates were not fully independent. This study shows that applying decision-based rules can reproduce a one-by-one review, increase transparency and efficiency, and provide a mechanism to replicate exposure decisions in other studies.
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Authors | Anjoeka Pronk, Patricia A Stewart, Joseph B Coble, Hormuzd A Katki, David C Wheeler, Joanne S Colt, Dalsu Baris, Molly Schwenn, Margaret R Karagas, Alison Johnson, Richard Waddell, Castine Verrill, Sai Cherala, Debra T Silverman, Melissa C Friesen |
Journal | Occupational and environmental medicine
(Occup Environ Med)
Vol. 69
Issue 10
Pg. 752-8
(Oct 2012)
ISSN: 1470-7926 [Electronic] England |
PMID | 22843440
(Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, N.I.H., Intramural)
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Chemical References |
- Air Pollutants, Occupational
- Vehicle Emissions
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Topics |
- Air Pollutants, Occupational
(analysis, toxicity)
- Algorithms
- Case-Control Studies
- Decision Support Techniques
- Environmental Monitoring
(methods, statistics & numerical data)
- Expert Testimony
- Humans
- Models, Theoretical
- Occupational Exposure
(adverse effects, analysis, statistics & numerical data)
- Retrospective Studies
- Surveys and Questionnaires
- Urinary Bladder Neoplasms
(chemically induced)
- Vehicle Emissions
(analysis, toxicity)
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